The Graduate School of Biomedical Sciences (GSBS) is collaborating with the Texas College of Osteopathic Medicine (TCOM) and the Arizona College of Osteopathic Medicine (AZCOM) in order to develop a Developmental Center for Research on Osteopathic Manipulative Medicine (DCR-OMM). OMM is a body-based therapy as defined by the NCCAM definitions of complementary and alternative medicine (CAM). The varied principles and practices of OMM are unique among other body-based therapies primarily because they are applied by fully licensed physicians and therefore can be applied to alleviate both musculoskeletal and visceral disease processes and readily integrated with conventional health care. Four key elements of osteopathic principles and practices will be investigated in this DCR-OMM: 1) Effects of direct biomechanical strain on the fascial tissues of the musculoskeletal system (Study #1); 2) Effects of OMM (lymphatic pump) on the lymphatic duct lymph flow and the resultant potential beneficial effects on edema and immune function subsequent to an improvement in lymphatic circulation (Study #2); 3) Effects of OMM on sympathetic neural activity either by affecting the sympathetic nervous system directly or by affecting the sympathetic nervous system indirectly by reduction of somatic dysfunction induced pain (Study #3); and 4) Combined synergistic clinical outcome effects which result from applying OMM in patients post-CABG who have a complex combination of fascial restrictions, pathologic fluid shifts, somatic pain and hypersympathotonia (Study #4). In 2001, the leading national osteopathic professional organizations endorsed and funded these investigators to establish a national Osteopathic Research Center (ORC) housed within the Physical Medicine Institute at the University of North Texas Health Science Center. The OMM research and research training missions of the ORC, supported in part by a 5-year NIH NCCAM K-30 OMM clinical research training grant, are perfectly aligned with the goals of the U-19 DCR-OMM. We are all dedicated to the success of this DCR-OMM with the express goal of developing into a P-01 Center of Excellence for Research on OMM to enable quality investigation and publication of the mechanisms of OMM.